Clinical

Radiotherapy improves outcomes of liver cancer with portal vein tumor thrombus

Last Updated: 2009-04-24 12:10:53 -0400 (Reuters Health)

NEW YORK (Reuters Health) - Radiation therapy after percutaneous transhepatic portal vein stenting and transarterial chemoembolization improves outcomes in patients with hepatocellular carcinoma complicated by main portal vein tumor thrombus, according to a report in the March 15th Cancer.

Main portal vein tumor thrombus compromises blood supply to the normal liver parenchyma and worsens liver function, the authors explain, thereby limiting the application of transarterial chemoembolization of hepatocellular carcinoma.

Dr. Xue-Bin Zhang from Zhong Shan Hospital, Fudan University, Shanghai, China, and colleagues compared long-term outcomes after percutaneous transhepatic portal vein stenting and transarterial chemoembolization with or without local 3-dimensional conformal radiotherapy used as a palliative treatment for 45 patients with hepatocellular carcinoma complicated by main portal vein tumor thrombus.

Cumulative stent patency rates and cumulative survival rates at 60, 180, and 360 days were significantly higher for patients who received radiotherapy than for patients who did not receive radiotherapy, the authors report.

Mean survival time was 496 days for patients who received radiotherapy, the researchers note, compared with 144 days for those who did not.

There were no severe adverse events or late radiation-induced complications in the group that received radiotherapy, the investigators say, and percutaneous transhepatic portal vein stenting and transarterial chemoembolization was performed successfully in all patients without major procedure-associated complications.

"This study further recommends the use of 3-dimensional conformal radiotherapy to improve results from percutaneous transhepatic portal vein stenting and transarterial chemoembolization when tapped as a method for preventing tumor thrombus from regrowing into stent," the authors conclude. Furthermore, they say, it also seems effective for improving patient survival.

Cancer 2009;115:1245-1252.